An unusual local complication of endoscopic nasobiliary drain catheter placement.

摘要

A 35-year-old man with severe right quadrant abdominal pain, fever, and jaundice was admitted to the emergency department. Physical examination revealed abdominal tenderness and tachycardia. Laboratory analysis at admission showed leukocytosis (17.200/mm3) with a sedimentation rate of 62 mm/hr. Ultrasonography revealed distal obstruction in the common bile duct with dilation of the biliary tree. The patient underwent endoscopic retrograde cholangiopancre-atography (ERCP) with a diagnosis of benign obstruction of the common biliary duct. The common bile duct was cannulated in ERCP and a guide-wire passed deep into an intrahepatic duct. The cannula was then removed and a 7 French (Fr) pigtail catheter with multiple side holes was threaded over the wire, which was then removed. The catheter was re-routed through the nose. After this successful procedure, the proximal part of the catheter was stabilized to the nose, as usual, by our endoscopy nurses.